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Kids, sleep and melatonin

We call our 2-year-old “the sleep bandit.” Every night we get our kids through the bath, in pajamas, and finally, after multiple stories and lots of kisses and snuggles, we close the last bedroom door. About 5 minutes later we hear her little feet… and we start the game of putting her back to bed, many, many times. She just won’t sleep. Out of desperation we tried giving her a little melatonin… it worked.

Lots of adults regulate their sleep with melatonin supplements, but what about kids? Is melatonin safe for children? Does it work?

About 25% of children take a long time to fall asleep—getting out of their bed and infamously asking for one more drink of water, one more story. In medical terms we call this “sleep-onset delay,” “settling difficulties,” or (my favorite) “bedtime resistance.” Bedtime resistance is more than just annoying to tired parents—kids who don’t sleep well can have behavioral, attentional and emotional problems. Many kids diagnosed with ADHD really just have poor sleep. Kids who sleep well do better academically, and are less likely to be overweight, get sports injuries, and get sick. We know melatonin is key to regulating the body’s natural clock, or circadian rhythms. To fix bedtime resistance we need to fix melatonin regulation.

Melatonin is a naturally occurring hormone that our bodies make. Healthy adults and children get a surge of melatonin about 30 minutes before they get sleepy. This melatonin surge seems to be trigged by a reduction of light. This is why we get sleepy when it gets dark. The trouble comes when our brain doesn’t release the hormone at the right times, and our sleep cycles get out of whack, such as when we are jet-lagged. The same thing happens to toddlers who miss naps, get sick, or just grow out of their regular sleep routines. This is where I think melatonin supplements may help kids—when they need to re-program their circadian rhythms.

But there’s not a lot of research about melatonin, especially in kids. So I was excited to read about a recent study that measured natural melatonin levels in 2.5-3 year-olds. It was a small study—only 14 children were involved. Much more research will have to be done before we can say these findings apply to most children. But the research showed that kids who were put to bed about 30 minutes after their melatonin surge fell asleep faster. Kids whose bedtimes were not in sync with their melatonin surge had bedtime resistance.

This research measured natural melatonin surges, the kind that occur when it gets dark (or lights are dimmed). Researchers actually showed up at these children’s homes, covered windows, dimmed lights, and took saliva samples. There is very limited research about melatonin supplements in kids. The data we do have mostly looks at children with developmental abnormalities.

Lots of parents give their children melatonin. You can buy the liquid kind with a dropper at any pharmacy for about five to ten dollars. It’s a cheap fix for desperate parents, like myself, who don’t have another hour to commit to bedtime. But here’s the scary part—we just don’t know the long term effects of melatonin in children. We do know that melatonin affects sexual maturation. If we give melatonin to children on a regular basis, will it provoke early puberty? We don’t know—this research has never been done. But it is a reasonable hypothesis based on what we know about melatonin. We also don’t know if the body down-regulates natural melatonin production if you take supplements, meaning that your child could become dependent on melatonin supplementation to fall asleep. Even if there is no physical dependence on melatonin supplements, children can become psychologically depending on their “magic medicine” to fall asleep.

I think it is fine to use low-dose melatonin supplements for children on a short-term basis (1-5 days) to help re-program their body’s clock if they’ve gotten off their regular sleep schedule. I would only do this in consultation with your own pediatrician, and after trying the above suggestions to get a child’s sleep schedule back on track.

Melatonin is not useful for kids who are waking up in the middle of the night. In these situations you need to do some trouble-shooting about what’s going wrong—is it illness? Anxiety? Too much napping? Is there a TV on in another room that is preventing them from sleeping soundly?

The sad reality is that there is no magic sleeping pill for kids. The good news is that kids don’t needmelatonin supplements—their bodies make it naturally. A melatonin surge about 30 minutes before bedtime means toddlers stay in bed and sleep well. We can trick their bodies into producing a melatonin surge when we want it. Here’s how:

Dim your house lights about 30 minutes before bedtime. Don’t wait until bedtime to shut off the lights. If necessary, cover windows to reduce natural light.

During the 30 minutes between light dimming and bedtime do quite activities together. Tell stories, sing lullabies, rock or snuggle with your children. Many families say prayers. If you need to read a book, use a small clip-on LED reading light.

Make sure natural light enters your child’s room in the morning. Natural light exposure during wake-up time is important for melatonin regulation. If you’ve pulled down shades before bed, open them after your child falls asleep to allow the morning light to shine in.

Make sure you’re not over-doing it with naps. If your toddler takes a nap from 1-3, they might not be ready for at 8 pm. Before considering a supplement, consider setting a later bedtime or shortening nap time. How much napping does your toddler need? See this article by Dr. Sarah Lenhardt. How much sleep does your child need? See this article by Dr. Kelly Ross.

Find a bedtime routine that you, as a parent enjoy. Stick to it. Make sure that all caregivers are using the same bedtime routine.

Kids need a regular bedtime and a regular wake time to keep their melatonin surges synchronized. This is the hardest part for parents—getting kids to bed on time means sacrifices on our part, like not staying out too late at another child’s activity. Sorry, no sleeping in on the weekends, either.

Address anxiety, nutrition, illness, and anything else that is preventing your child from falling asleep. Kids can have anxiety over things we never imagined. They won’t tell you unless you ask.

Sleep is a life skill that we, as parents, need to teach our children. When we teach our children healthy sleep routines, we give them so much more than a schedule. We give them health, energy, attention, and cheerfulness that will last a lifetime. We get a more peaceful home. And we get to sleep more, too.

Comments

Carolyn

Great article! However, I’d sugest not opening the shades until morning unless you live in a neighborhood that is absolutely dark all night long. Ambient light from outside can disrupt sleep cycles, too.

Tina Poteet

Worried about grand children on melatonan Afread it will compromise their natural ability to produce this brain chemical. HELP…WORRIED GRANNY

Jenny

What if your toddler does wake up in the middle of the night? My daughter will wake up in the middle of the night, and I’m assuming gets anxious because she can’t fall back to sleep and stays up for hours sometimes. What do you do then?

Abby

Jenny, I also have the same problem with my 4 year old and was doing some research to see if it would help him. Our real problem is, whenever we transferred him to a twin size bed from a crib, I said I would sleep in there with him til he got used to it. Well, it’s been hard to break the habit. We even got him a car bed that he loves but he wants me in there with him! After he falls asleep, I get into my bed but he wakes up every single night and yells for mama. He must notice I’m not there beside him and wake up. We are running out of ideas and a friend suggested melatonin. But this article said it wouldn’t keep the child asleep, which is what we need! I am 9 months pregnant with #2 and I need to get out of that bed! I can’t be laying in there with my c section and I don’t want to keep doing this habit. I had my husband get ear plugs for himself. I know it will take time and I just wish I had never started the bad habit

renee

What is the youngest age that melatonin can be given? I have a 19 month old, 30 lb grandson, that doesn’t sleep well. What liquid dose do you suggest?
Many thanks,
Renee
I would like to know the answer to Jenny’s question about the toddler waking up in the middle of the night…nothing is working 🙁

Kylea

Tina Poteet, you’re right to worry that it will impact their ability to naturally produce the chemical melatonin. You will hear that there is no impact on the body from taking melatonin; this is true, to an extent. The melatonin supplements on the shelf at stores have not been evaluated by the FDA and the doses can vary widely, from half the dose that the bottle says per gummy, all the way up to double the dose or more per gummy. This is because it is not closely regulated at all, and there are no requirements. They do not have to prove that it is safe in order to put it on the shelves. The bottle recommends that you only take the supplement a few days at a time. Taken in these small doses, no, it won’t have any side effects in adults. There have been sparse studies on the effects of melatonin in children, so we don’t really know what consequences regular use could have. The problem with melatonin is, it will get you to sleep, but it won’t keep you asleep. If used in young children for too long (which, we don’t have a time frame of how long too long is, since there have been very few if any studies on it) the effects on the child can be dependency on the product, which comes from the atrophy of their pineal gland in their brain. This gland produces the hormone melatonin, which works in a rhythm with cortisol. Cortisol is most commonly known as the “stress hormone” while melatonin is most commonly known as the “sleep hormone.” Basically, your levels of cortisol are higher in the morning and lower at night, while your melatonin levels are lower in the morning (allowing you to get out of bed) and higher at night (allowing you to go to sleep). Using a melatonin supplement not only disrupts this natural cycle in the body, child or adult, but it also causes the pineal gland to quit making the hormone, because it is already getting it elsewhere, and so production isn’t needed. Another problem with adding a melatonin supplement is that children naturally make more melatonin than adults. They’ll sleep when they get tired. One way to allow melatonin to do what it does is to limit access to bright screens and bright lights starting about an hour before bedtime. This allows melatonin levels to naturally increase in the child’s system, which will make them fall asleep. I don’t mean to alarm you but other possible side effects of long term usage in average children (not autistic or ADHD) is early puberty, an impact on sexual development and growth, dizziness, headaches, nausea, feeling fuzzy during the daytime, dependency on the melatonin supplement, an eventual resistance to the melatonin supplement which will make you increase the dose that you need to have the desired effect. My boyfriend’s children, 2 and 4, were being given adult doses of a melatonin supplement which prompted my research. It is unclear whether this is still going on but I entirely understand your fears, because they’re mine, too. Good luck, and I would recommend stopping the dosage if you have any influence.

To Renee, I would absolutely NOT recommend giving a child that age any sort of melatonin. Their bodies already make more melatonin than an adult does, they don’t need any more. Also, if the problem is getting him to stay asleep, Melatonin will NOT solve your problem. Melatonin only makes you fall asleep, it doesn’t make you stay asleep. To help a child stay asleep I would say try to make sure the room is dark and there are no loud noises waking them up at night, and play with them to wear them out during the day or a couple hours before bed, if possible. Also, large meals make anyone sleepy. Maybe that will help?

Good luck, everyone. Please don’t believe that an “all natural” supplement means that it isn’t harmful!

Emma

what about melatonin that is compounded by a pharmicist in accordance with a doctors script? Is that a bit different to melatonin you buy over the counter?
I have a 7 year old child with autism – I used the melatonin for 2 years from ages 3 – 4. It was a lifesaver and now he is great at going to sleep. I have another son who is 5 – he does not have any diagnosis although borders I am sure on ADHD and I am contemplating using Melatonin for him. I was always told by paediatricians and other professionals that if the melatonin was compounded properly it was ok however if you bought it over the counter you couldn’t be sure of what was in it. I would be interested in what your thoughts were on that….

Masha

My 5 year old brother wont sleep stays up all night any medicen i can give him to help him?

Other considerations for helping with normal circadian rhythms is using red “party lights” at night while reading or moving around. Red spectrum light doesn’t interfere with natural melatonin production, as the nocturnal exhibits in the zoo demonstrate nicely. And they also make sunrise simulator alarm clocks that slowly brighten a room at whatever hour you chose. Make the wake-up time consistent so the “body clock” doesn’t get off schedule. And make sure you chose light bulbs that are dimmable. For parents with smart phones who like to read them in bed, my kids (grown) found that using red text with a dark black background works. Unfortunately, the default blue/white color light that most led screens emit are the best for waking people up. (Like the color of the sky on a bright morning).

Joy

I am giving my 3yr old 2mg of melatonin at night to fall asleep, we also give him 2mg when he wakes in middle of the night. Without it he will not fall asleep and sleeps very little even when he does. In addition he is very aggressive sleeper, meaning he is allover the place and rolling around, often waking himself up. He is autistic and is under direction of pediatric pulmonologist with specialty in sleep study and this is the route we decided upon. Prior to the melatonin he was on clonidine for the sleep disorder but that gave him nightmares. Now, he is able to get good blocks of sleep which is helping him during the day. He is still not sleeping more than 3-4hrs at a time, but this is providing some improvement. Its always a hard decision to put your children on medication, but sometimes parents just have to make the hard choice to do so if it will help them. Even though melatonin is naturally produced in the body, in children with disabilities it often times not produced. I would certainly never say “don’t ever give your child melatonin”, I’d say consult with your doctors on your situation and make sure its given for the right reason.

I have a 3 year old son who is on melatonin after a year and a half or trying to get him to sleep became a real struggle he would wake in the night for up to 5 to 6 hours at least 5 nights out of 7 he is under the hospital and he prescribed him melatonin he has been on this medication for 3 months now and since the day it got proscribed he has slept every single night without any trouble he wakes for a drink in the night but then naturally drifts back off to sleep within 10minuites I give him the medication at 7.30pm take him to bed in a dark quite room and read a book within 15minutes of medication he is asleep before he had melatonin he used to do strange movements with head and hands as if he was having a seizure and usted to shout out things as if he was talking to someone he is on 2mg of melatonin and I would recommend it to and parent that is or has gone through the same this as I have experienced with my son it is a very good medicine and I’ve seen a massive improvement in my child also in his behaviour he seems more relaxed and not at busy as his brain usted to be.

Jodi

My two year old twin girls went from 10-12 hours of sleep each night to 5-6 since their second birthday. They were very well sleep trained; I had never sang, rocked or even had to stay in the room with them to get them to sleep. Then they would sleep in until 8 am or just sit and look at a book until then. Now they will scream until they vomit, and try relentlessly to climb out of their cribs any moment they are awake. They have become terrors during the day because of their restless nights, and I am at my wit’s end. My husband has ADHD and has always had trouble with sleep and nightmares, so I suppose it’s going to be the same for them. We’ve tried lavender and Vetiver essential oils, to no avail. I hate to give them anything else to get them to sleep, but I think I’m going to have to in order to get my sweet girls back…. Oh, and my sanity. I need that back too. Any advice? Or encouragement?

I didn’t know there was a medical term for when my kids refused to go to sleep, and I think “bedtime resistance” is the best term. I know that when I was a kid I hated going to sleep and would be awake for at least an hour after bedtime. Because of this I thought “bedtime resistance” was natural. So, thanks for posting this, now I know that there are sleep aids for kids.

We have been giving 1mg per night to my 3 1/2 year old son on and off for about 6 months. With out it, he does not fall asleep until 11pm – midnight, sometimes even 1am every night. When he falls asleep that late, mornings are rough and he is cranky during the day, hitting other kids, etc.. On top of that, my husband and I cant sleep until he falls asleep, we are often late for work in the morning and we became tired and cranky too. On melatonin, he falls asleep around 8:30pm. He gets the sleep he needs. He is no longer misbehaving at pre-school. Mornings are no longer high stress.

We have tried to take him off the melatonin, hoping it would re-set his clock. We just went right back to our old challenges. Now we dont know what to do.

Tracy McCord

Masha. Let your mother take care of it. And if you are his caregiver consult his pediatrician. Kylea Your comment in addition to the article was very helpful. Thank you!

Aliraona

I gave my daughter a melatonin the next day she was on her period and I took a melatonin and then I was on my period

Joi

My son is 14, just started puberty with in the last year. He’s currently on vyvanse for ODD and ADHD. I’ve given him melatonin since he was 8. I would say his beginning of puberty is right on schedule. If that info helps anybody. P. S. Loved the article. Very informative.

Sandra McDaniel Gordon

Hi there. I have a 7 year old son who has ODD and ADHD (diagnosed about 1.5 years ago). I would love to get some advice from another parent who has experience in this. If you are willing for me to pick your brain a little would you email me ? Sandragordon85@gmail.com

Constance Wagers

My son is 7 years old he’s been diagnosed with ADHD for 3 years now I will not give him melatonin he was waking up with nightmares from it so I talk to his pediatrician and she prescribed him clonidine he take 1 and half a night sleep all night no nightmares no fighting his sleep no nothing yall might want to look into getting them on something that isn’t over the counter

Shannon Bailey

My daughter is 3. she has had a problem with sleeping since she was 15months. He docs put her on medicine that is used to make adults calm or either go to sleep. I had to give her half a teaspoon. It did not work. She doesn’t refuse to go to sleep, she just doesn’t get sleepy until around 4 or 5 am. I struggle myself only getting about 4 hours of sleep every night. Majority of the time, she doesn’t even take a nap. Some people have suggested melatonin to her sleep and regulate her night time pattern. I am going to take her to the doctor Friday and hopefully they give me a solution or agree on the melatonin because I don’t know how much longer I can take it. Her appetite has dropped, her attitude has changed, and she seem very inattentive.

Rachel Humphrey

All natural means it’s naturally made but this dose is NOT natural. There has been no proof that the dose given to children is in any way good for them or is harmless.

Marie Lee

Did I miss it, but does it cause nightmares? My son is 3 and for the past week he keeps waking up

Anastasia

Did you ever get your son off the Melatonin? My son is 4.5 years old and he has autism so sleeping was difficult. He has been on Melatonin for about 6 months now and not sure if I should take him off or not. He sleeps about 10-11 hours a night with it from 8-6am.

Kait

My 3 year old daughter has always been a terrible sleeper. In fact, she hasn’t slept an entire night through in her entire life. She does not have any disorders that we are aware of and is perfectly healthy. She doesn’t nap. Even as a newborn she was awake more than most, the nurses were all stunned when we were in the hospital because every time they checked in on us she was awake. It has taken me 2+hours at least for the past 6 months to get her to sleep. We usually lay down a little before 8, after she’s had a full meal and a bath, to read roughly 5 bedtime stories. Most nights she doesn’t go down until after 10, if I’m lucky shes out by 9:30. I gave her melatonin for the 1st time tonight at 8 pm and she was asleep by 8:30. Here is my problem, I am super paranoid. I’ve never given her anything to help her sleep (she’s never even had medicine that would make her drowsy such as Benadryl) I got the 1mg, I halved it then I halved it again and gave her 1/4 of the tablet. Now she is asleep and I still can’t sleep because I’m afraid that she will stop breathing or something (I realize this is probably a ridiculous thing to fear) have any of you parents out There ever experienced anything negative with giving your child melatonin?

Nanny

This is a Huge eye opener. Thank you!

Elvia Aguilar

My grand daughter has odd and adhd…her Psychiatrist tol me to give her Melatonin to help her sleep….she sleeps fine now and all night.

Brittney Burns

Perhaps try chamomile tea?

Dena Byers

I have a 3 year old daughter doing the same thing about one to two times a week. I also have considered taking her to her pediatrician. It’s very frustrating. What did you find out from her doctor?

Shannon Bailey

they diagnosed her with insomnia. She still has her up and down moments. I really don’t like giving her meds and he Dr. doesn’t want her to be dependent on the gummy melatonin vitamins. I have cut all and any daytime naps (if she takes one) to 30mins just to keep her from being cranky throughout the day. I have also cut all exciting things around 9pm. So we watch the news or weather channel. lol. Sometimes I even do exercising and breathing exercises with her to calm her down some. Now she’s not an all nighter. Sometimes it will be 1 am and on bad days 5am. but 1 is better than 5 and will definitely take that. It takes time to get them used to the different things but I have found it to work..

alaskanrose

It’s irritating that research says be wary of giving melatonin, but then only give non-helpful advice like sleep hygiene. All three of my children either are or were terrible sleepers, and sleep hygiene doesn’t do anything for kids like mine. I haven’t slept through the night in about 7 years and I need a break! Melatonin helps.

Jessica Benning

Its very important to know the risks of melatonin vs the benefits. Even though there hasnt been much research there is enough to know long term use for children isnt good. As far as puberty goes its not going to provoke early onset as stated above it actually does the opposite. It can cause girls to have smaller than normal ovaries and boys to have smaller testes. Worse case scenario become infertile. Actually there is study going on in the Netherlands about using Melatonin as a contraceptive. Also the reason for headache being one of the side effects is because is causes vasoconstriction to the brain. Even though its a” natural ” hormone we produce Melatonin supplements are still a synthetic version of this and have several other risks I didnt even mention. And as mentioned in the previous article there hasnt been enough research long term on the however I would seriously consider what we do know before giving this to our babies. Im a pediatriciatric nurse and used to give this to son and no longer do. Just a word from the wise….

Lisa Marie

how safe is it for a 1 year old my brothers daughters mom gives this too her

Darlene

We adopted our grandson who was born badly drug addicted, is on autism spectrum, etc. We are needed to find a drug free way to help him calm down and maintain a sleep pattern as his varies all the time. We do not want to use a chemical drug for any of this as this could start the addiction issues all over again. Is there an alternative naturally to melatonin?

Darlene

Sometimes the time of day they were born has alot to do with it. My daughter was born at 526am, and was sleeping through the night fairly early and continued to reliably do so, my son however, was born at 10:26pm, and was awake for awhile after birth, I did not use any kind of drug during delivery for either child. He was/has and is a nightowl. He loves working nights. Had a devil of a time during school years as i would check on him at night around midnight or so, he was still wide awake…I think sometimes it depends on time of day they were born. He’s 30 and is still a nightowl.

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